The research subjects are patients admitted to the Intensive Care Units (ICU) of four community hospitals. Two hospitals will be control and two hospitals will be treatment. The control will continue routine ICU oral care while the treatment ICUs will be instructed in the systematic oral care technique. The patients will be examined and tested on Day 0, 3, and 5 of their ICU admission. All testing is considered non-invasive: Beck oral assessment, mucosal plaque, risk assessment, Apache II, and clinical pulmonary infection scores. Additionally saliva and plaque specimens will be collected and moleculary assayed for the presence of bacterial pathogens. data collection started in October 2004 and concluded in April 2007. Data analysis is ongoing.